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ADAP May 6th Watch List**Louisiana has a capped enrollment on their program. This number is a representation of their current unmet need.Eighteen ADAPs, 10 with current waiting lists, have instituted additional cost-containment measures since April 1, 2009 (reported as of April 13, 2011). In addition, 14 ADAPs, including four with current waiting lists, reported they are considering implementing new or additional cost-containment measures by the end of ADAPís current fiscal year (March 31, 2012).

States that have instituted cost containment measures and those considering them, in addition to implementing waiting lists, are reducing program financial and medical eligibility, capping enrollment, reducing the number of drugs on the formulary and cutting other services, all of which impact access to life saving HIV medications for medically vulnerable individuals. - from the ADAP Apr 21th Watch List

Just spoke with a friend of ours, that we've known here in Florida for the past 28 years. He has spent the last 8 months in Mississippi. He simply said what a fucking mistake that was. He has relatives up in Vermont, says he needs to get of this fucked up State of Florida. Can't say I blame him.

Just spoke with a friend of ours, that we've known here in Florida for the past 28 years. He has spent the last 8 months in Mississippi. He simply said what a fucking mistake that was. He has relatives up in Vermont, says he needs to get of this fucked up State of Florida. Can't say I blame him.

He'll be moving to Vermont in two weeks...

Ray

Ray, I'm not clear is he in Mississippi or Florida now?

Logged

Diagnosed in May of 2010 with teh AIDS.

PCP Pneumonia . CD4 8 . VL 500,000

TRIUMEQ - VALTREX - FLUOXETINE - FENOFIBRATE - PRAVASTATIN - CIALIS

Numbers consistent since 12/2010 - VL has remained undetectable and CD4 is anywhere from 275-325

I keep warning people to pay attention to this list, and to do your research, before moving. If you use ADAP and there's a waiting list, then moving there must be taken out of the equation. Likewise, if you're thinking about moving to an area without an ASO be prepared to handle your own paperwork and difficulties.

These sorts of notions go hand-in-hand with the other thread about ID vs GP doctors for HIV+ person's healthcare. Urban areas with higher concentrations of HIV+ positive people are more likely to have better health care resources than rural areas with limited health care facilities, few ASOs, and scattered doctors in general - not to mention the pesky ADAP and state Medicaid funding issues.

technically with the budget (last years FY2010-2011) finally signed, SC could force all HIV+ Medicaid and ADAP users to only use generics medications. Thank goodness the heads of HHS and DHEC understand that azt and ddI are no longer first line approved treatments. For the time being, they are not changing policies nor requiring "approval" for non-generic meds.

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Austin, in and of itself, is a GREAT place to live. It's just our moronic Republican legislature that creates the problems. I hope to get on Texas ADAP before all of the new criteria goes into effect in the fall. My app went in a couple of weeks ago. Now getting ASA services, that is a WHOLE nuther story.

I was put on the list in March, I live in FL. Started meds April 10th, being paid through RxYes (PAP). There is over 3,500 people on the waiting list. How long is the wait? Will it take longer than a year? How do they make more room I mean do you have to wait for someone to move/die or ADAP to get more funds? I am clueless how the whole thing works. I have been positive for 7 1/2 years and wish I would have started meds back before there was a waiting list!

I mean do you have to wait for someone to move/die or ADAP to get more funds?

the federal government could offer more funding to help clear the waiting lists.

Your state government might put more funding into the ADAP system - depending on when the budget is being voted on. (for example in SC, for the FY2011 budget, we asked for $6 million to cover the current amt of clients and an additional $4 million to cover the projected new clients. The budget has been signed with only $5 million for ADAP, so we're screwed without enough money this year)

However, as Florida ADAP went broke 2 months before the fiscal yr ended last year, there probably won't be enough money to cover the current client list for the entire year. Looking for additional funding from the state probably won't happen with the current governor and legislature.

And yes if people move out of state, get insurance to cover their meds, go onto state medicaid, or gain federal disability (and medicare), then other people will move up the list

SC already caps all taxes at $300 One "ask" at a rally a year ago was to raise the cut-off to $400. I don't remember exactly how many more millions in revenue that was supposed to bring into the state coffers but it was a lot with just a small increase. These Republicans with their crazy financial policies are going to be the death of someone yet.

I've been on the waiting list here in Ohio for quite some time now. I had to be "creative" to qualify for state Medicaid while awaiting SSD. I had recently asked my case manager where I stood on the waiting list and she said they can't really tell where you're at on the list or how long it could possibly be. I then indicated that I probably should go ahead and withdraw my request since I no longer am in dire need of their assistance thanks to Medicare and prescription coverage. She said I should stay on the list just in case and remain on the rolls once I'm approved.

I wonder if these types of situations aren't contributing to the problem? Are people remaining on the program because of the fear of loosing future help if the need arises? Just like so many others, my greatest fear of returning to work is the idea of being without medical assistance sometime in the future.

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Complacency is the enemy. Challenge yourself daily for maximum return on investment.

On the outset I'm fine with this. This sounds like a business decision any Corporation in the US would make. If your competition (Florida) has a lower overall price on a product (Yacht Tax), and you are losing business to your competitor because of this (Texans going to Florida to buy Yachts), then why wouldnt you entice your customers to buy from you (lowering Yacht tax) and keep the money in Texas? Isn't it better to get SOME tax income on these yachts rather than get none? I would say yes.

However I would need to know more info, such as are Texans really going to Florida to purchase their yachts, and if so how many? What was the income gained from YAcht Tax in texas prior to Florida lowering their tax compared to what it is now. Is it really that much money? Or is this just a loophole for the blue bloods to get a cheap Yacht?

The only thing I can say is you cant swing a dead cat on the Texas coast without hitting a yacht, there's a ton of them.

Since you take such an interest in Texas tax collections perhaps you can find this info for me, cause I have some whacking off to do at the moment.

-WIll

Edited to add: In between my jack off sessions I did find this:

Since July 2010, at least 35 Texas residents have purchased and registered their boats outside of Texas, at an average price of $800,000 each. Boats purchased outside of Texas must be kept out of Texas for at least four years to avoid being taxed upon their return to our state. Over that four-year time period, we lose the sale, the sales tax, the dock fees, the repair and maintenance expenses, the fuel sales and most importantly, the jobs. It is estimated that the owner of a yacht puts 10 percent of the purchase price of the boat back into the economy every year. That means that the Texas owner of an $800,000 yacht is pumping $80,000 into the Florida economy every year. This should be happening in Texas.

As chair of the Economic and Small Business Development Committee, one of my responsibilities is to find a way to protect and create jobs in Texas. The marine industry is important not only to my district around Clear Lake, but to the entire state of Texas. This bill is not a haves versus have-nots issue; it's about jobs and economic development. It's not a Democrat versus Republican issue, which is why one of my Democratic colleagues in the House filed a similar version of the bill this session that would have implemented a $15,000 cap on sales taxes on boats.

It also noted that the average sales tax bill on these yachts is approx $18,000 per yacht. Even if it was capped at $15k, Umm yeah, I think Texas would like to ahve that money.

I had to be "creative" to qualify for state Medicaid while awaiting SSD. .... She said I should stay on the list just in case and remain on the rolls once I'm approved.

I wonder if these types of situations aren't contributing to the problem? Are people remaining on the program because of the fear of loosing future help if the need arises?

ummm, what if you didn't have your "creative" solution? What if my ASO could not longer afford to buy the meds for the people on the wait list? I think your solution and the local solution here are only temporary solutions - similar to how welvista covered all those Florida ADAP people for two months. Just because some people are able to find temporary access to their meds doesn't mean they don't qualify and shouldn't be getting a more permanent solution through the system (ADAP funds meds on a annual of bi-annual schedule so it's at least a much more stable solution).

It's actually quite amazing and you're quite lucky if, even though you financially qualify for assistance, you are able to get your meds covered. If you're ever fully enrolled onto ADAP you could find your co-pays or premiums covered. Most people that qualify financially don't have the ability to cover the costs of meds or find a "creative solution" to get partial coverage through medicaid.

However there is such a thing as an 1115 waiver which could help with these cases in a similar way to your solution. This waiver allows the state to give someone medicaid access to meds, who normally wouldn't qualify for full disability or medicaid. Think of it as "partial disability" that would give you meds but not cash. This would enable people to continue working and receive meds without struggling to have disability approved or losing everything to become financially qualified.

ADAP May 12th Watch List**Louisiana has a capped enrollment on their program. This number is a representation of their current unmet need. ***Utah instituted a waiting list in May 2011. To date, no individuals have been added.

I'm not sure if I didn't write it correctly or if there was a misunderstanding. I completely agree that ADAP funding needs to be corrected. When I found myself in the situation of needing help with meds, there was no help available. We already had a waiting list and Medicaid only covers those without any assets at all. I was talking about being creative in the sense, that on paper, I looked poorer than a church mouse. I had already been working on this issue because of the state of my health at the time. By the time I applied for Medicaid, I no longer had any banking accounts, no property in my name,only had a title to an old pick up, and no cash on hand. They covered my drugs until I rec'd SSD and I now pay for prescription coverage that covers my drugs...albeit with co-pays.

Logged

Complacency is the enemy. Challenge yourself daily for maximum return on investment.

By the time I applied for Medicaid, I no longer had any banking accounts, no property in my name,only had a title to an old pick up, and no cash on hand. They covered my drugs until I rec'd SSD and I now pay for prescription coverage that covers my drugs...albeit with co-pays.

I don't think I fully understand. Do you have SSd/Medicare and Medicaid right now? If you have both, then your meds are basically fully covered. Unless your case manager thinks ADAP will cover your co-pays, then you probably should drop the ADAP application as they won't be able to do anything for you.

They didn't pay co-pays for me when I was living in OH (but they did pay the Medicare premium). I had to pay $15 a month in co-pays - when before part D went into effect, I didn't have to pay any. go figure that government help would actually cost! LOL

However, if you don't have Ohio state Medicaid; but you do qualify for ADAP, then I would keep the application in the system because when approved ADAP should pay either the Medicare premium or the co-pays, or perhaps both.

I stopped getting any Medicaid assistance once I rec'd SSD. I'm over the threshold limit for any assistance but I pay a premium for medical/hospitalization and another for my prescription drug plan. I didn't realize ADAPS pays the premium, that would save quite a few bucks.

Logged

Complacency is the enemy. Challenge yourself daily for maximum return on investment.

I didn't realize ADAPS pays the premium, that would save quite a few bucks.

and it saves ADAP money too.

Rather than having to pay for someone's entire prescriptions, they often pay for someone's medical insurance premiums (like your Medicare, or someone working with insurance but still financially qualified) and the insurance covers the prescription cost. As a payer-of-last-resort this actually allows ADAP to help more people. When states have a high FPL requirement, this is how it is often done to cover those with very limited resources and those with much higher financial resources.

That also goes back to your original query. When the FPL has been dropped as a cost-saving measure, the people that get dropped from the program are not at the lowest incomes. Then those who are dropped have to cover their own co-pays and premiums. ADAP realizes some cost savings (though not huge amts); and the former clients don't suddenly have to pay thousands for their meds either; but have to pay out hundreds to cover the copay/premiums.

So really people in your situation, and those making a higher FPL who have ADAP pay premiums/copay don't really cost the system that much and it's worth those people staying on the ADAP waiting list, because helping people get access to meds helps insure adherence, lower transmission rates, and less healthcare costs for healthier people.

Greg in some states ADAP has a cut-off limit, and some states have done away with the upper 300% FPL I'm @ the middle end of the FPL @ 250% to 275% and I still get ADAP in my state, but had to use my states risk-pool-ins to get THIS, as my Medicare Part "D" just wouldn't have made the cut, I would have ended up paying $700 to $800 a month just to get my MEDS, and that would have been almost half if my monthly income, so that just would NOT have worked for me hence the risk pool ins. I like you, don't qualify for any Medicaid, food stamps or anything thing else

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

I would have ended up paying $700 to $800 a month just to get my MEDS, and that would have been almost half if my monthly income,... I like you, don't qualify for any Medicaid, food stamps or anything thing else

lordy! half your income is what my total monthly income is. that was just one of the disadvantages of getting this disease and being so sick/disabled at a younger age. It's why I often counsel those more recently diagnosed to continue working as long as possible - you don't want to end up homeless or eating cat food because you didn't earn enough before you got to your senior years.

sometimes though I do have to wonder if being as poor as I, and others are, doesn't put us in a better position to get better, or at least less stressful, healthcare. So I guess, when push comes to shove, I'll take being dirt poor (it's not like I have much choice in the matter anyway ) AND having meds any day over the hassles that others have trying to get meds when their income is "too high".

Nothing in the world wrong with getting whatever help you my need, your not poor, if you can get what you need, I have learned in my almost 14 yrs. that you can make a dollar go far, as cheap as I'm, my otherhalf hollers @ me all the time, and tells me just how CHEAP I'm, it drives him BAT SHIT

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

3,156 people have been added to the waiting lists in the first 5 months of 2011, since the first report on Jan 7th when the total was already 5,154. These people are eligible for HIV meds, not only because of their financial status but because of their cd4 and viral load status. While some have found temporary arrangements, others quite possibly have gone nearly a year without medication.

ADAPs with Waiting Lists(8,310 individuals in 13 states, as of May 19, 2011)(changes from May 12th noted in parens (+210))

Illinois tightened the eligibility for the state program that helps HIV patients pay for their medications. On July 1, the cutoff for the program will fall from an annual income of 500 percent of the federal poverty level, or $54,450, to $32,670.

Georgia cut $100,000 from its program, which serves 4,300 people.

Florida, which already has the nationís longest waiting list for HIV prescription drug assistance, held public hearings as officials consider cutting the eligibility threshold in half to $21,780 or less in annual income.

Utah and Alabama are reopening their waiting lists.

Quote

Thomas Decker, 58, an HIV patient in Arlington, was laid off from his job with a local printer in September 2009. He continued to buy his insurance through theCOBRA program, but when that ran out, he turned to ADAP.

ďItís such a shock when you have insurance and you pay into everything for so many years and then you are just sort of left out into the open ó people really donít get it,Ē Decker said. He was forced out of the stateís ADAP in January when his T-cell count increased, suggesting his health was improving. ďI was kicked off the program basically because of my health. I always kept my health up,Ē he said.

Decker moved to Virginiaís waiting list, along with 684 other individuals. He is also enrolled in a pharmaceutical assistance program that provides medication.

I am not that able to research this type of info but personally I have not had any problems receiving neccessary med and script help in both Florida (1994 - 2003) and NY State (2003 = present) obtaining any assistance from ADAP. I receive around 13-15 scripts per month + doctors visits for labs and check up monthly with no out of pocket expenses for anything.I recently spoke to a case manager at my Doctors office (a regional ASO) who advised me to stay with everything the way it is at present and not to even attempt to receive Medicare or Medicaid assistance. If I tried to do so, I would lose my ADAP eligilibity and would be forced to come up with a good % of my med and doctor costs. Seeing that I only receive $1200/mo SSDI, I would be in excrutiating pain then dead in a few months without ADAP and the services of my Clinic. My heart goes out to those who struggle with this on a monthly basis!I do need to add South Dakota to their list as I recently did some investigative work in getting qualified for ADAP in that state to help care for my elderly mother. I was told it would be around 2 t o3 years before I would even be seen for an appointment to start my care...I would be on my own with no sort of assistance available and even if I survived long enough to get to where they could assist me. Move to South Dakota and simply sign my death certificate would be the only thing I could look forward to!!

By Elton John and David Furnish, special to the TimesIn Print: Friday, June 3, 2011

Florida faces a significant AIDS crisis. One in every 205 Caucasian men in the state is HIV positive. So is one in every 113 Hispanic men, and one in every 42 African-American men. In Florida, like elsewhere in America, AIDS is the leading cause of death for young African-American women.

The severity of this crisis is why more than 9,600 low-income Floridians rely on the government for help to afford lifesaving AIDS medications. These drugs are made available through a state-run initiative, the AIDS Drug Assistance Program, or ADAP, administered by the Florida Department of Health. On its website, the agency says that one of its lifesaving missions is to help AIDS and hepatitis patients who otherwise cannot afford their medication.

Yet a proposal under consideration by the Department of Health would undermine this mission by drastically reducing the number of low-income Floridians who qualify for ADAP. (A department spokeswoman told the Associated Press this week there are no immediate plans to change the program, though it held hearings to discuss the possibility of lowering income requirements to participate.)

This cost-saving move would exclude all but the state's poorest residents ó those earning less than $21,780 per year. If this happens, more than 1,600 people who receive ADAP assistance would be cut from the program, and the nearly 4,000 residents already on a state waiting list ó the nation's longest ó would have no hope of ever receiving assistance.

Granted, we must tighten our belts during tough economic times, and spending decisions must be prioritized. But ADAP should not be the first place to look for cost savings. It should be the last. After all, the consequences of cutting back this program are, quite literally, life or death.

Given that lifesaving antiretroviral medications can cost between $10,000 and $30,000 per year, the proposed ADAP eligibility change would put low-income individuals with HIV/AIDS in the untenable position of being unable to afford essential treatment for an incurable, communicable disease. With treatment, these Floridians can lead healthy, productive lives. Without it, they will slowly die.

A better proposal would be to fully fund ADAP for all those who need but cannot afford treatment. Indeed, in a time of budget concerns, fully funding ADAP would be not only humane but fiscally prudent; it would save significant health-care costs over the long run that would be otherwise paid by the taxpayer.

The Elton John AIDS Foundation has invested significant funding for HIV/AIDS prevention, stigma reduction, treatment, care, and associated services for those living with HIV/AIDS in Florida. We stand in solidarity with our grantees and partners in Florida who are deeply concerned about the tremendous harm this proposal would cause in the communities they serve. And we echo and applaud Sen. Bill Nelson, who has written to Gov. Rick Scott and President Barack Obama about the unacceptable lack of funding for ADAP in Florida.

At the outset, we offered a few statistics to broaden the public's awareness. We'll close with an appeal to broaden the public's heart. We hope Floridians will show compassion by treating those who are suffering as if they were their own friends and family. Indeed, this is all too often the case.

Musician Elton John and filmmaker David Furnish are the founder and chairman, respectively, of the Elton John AIDS Foundation, which has raised more than $225 million for HIV/AIDS treatment and prevention since 1992.